What we think: Disease label for obesity could set back progress

July 11, 2013

When the American Medical Association declared obesity a disease last month, the nation's top physicians' group didn't just label more than a third of Americans as sick. It also eroded the element of responsibility —personal and public — behind this growing health problem.

Some 35 percent of Americans are obese, according to federal statistics. The rate has risen sharply since 1980, when it was about 15 percent. The annual cost of treating obesity and its many related health problems has been pegged at $175 billion.

Of course, weight control isn't always as simple as eating better and exercising more. At a forum convened by the Sentinel last month, expert panelists talked about the complex factors that have contributed to the skyrocketing rate of obesity. They cited the cheap cost of unhealthy foods, more acceptance from peers who are also overweight, and living and working in technology-rich environments that discourage physical activity.

And genetics can make keeping pounds off easier for some folks than others. Your office mate who devours a pizza at lunch every day while you nibble at a salad might have a lower body-mass index than you do, and your parents might bear at least part of the blame. Life is unfair, as President John F. Kennedy famously said.

Supporters of the AMA's declaration believe it could persuade more physicians to take seriously obesity among their patients, and could lead insurance companies to cover weight-reducing treatments, including drugs and surgery.

But doctors shouldn't need the verdict of the AMA as cover to confront their obese patients with the obvious health risks they face — including diabetes and heart disease — no matter how uncomfortable it might be.

And telling obese people they suffer from a disease could lead them to give up on taking more control over their health through changes in diet and exercise. They might be more likely to turn to aggressive, expensive and sometimes risky medical intervention, or seek disability status.

A disease label for obesity also could deflect blame from other contributors to the problem. Like federal lawmakers, whose subsidy programs make unhealthy food made from corn much cheaper than fresh fruits and vegetables. Like local governments that neglect parks and recreation programs. Like food manufacturers that manipulate levels of sugar, salt and fat in their products to hook more consumers.

No matter what their body type, people deserve to be treated with dignity and compassion. Obesity is not a moral failing.

But downplaying the role of responsibility in treating it is the wrong remedy.